Harissou Adamou1, Oumarou Habou2, Ibrahim Amadou Magagi3, Ousseini Adakal4, Amadou Magagi5, Maazou Halidou6, Rachid Sani7. 1. Department of General Surgery, Faculty of Health Sciences, Zinder National Hospital, University of Zinder, PO BOX: 656, Zinder, Niger. harissou1976@yahoo.fr. 2. Department of Pediatric Surgery, Zinder National Hospital, University of Zinder, Zinder, Niger. 3. Department of General Surgery, Faculty of Health Sciences, Zinder National Hospital, University of Zinder, PO BOX: 656, Zinder, Niger. 4. Department of General Surgery, Regional Hospital, University of Maradi, Maradi, Niger. 5. Department of Urology, Zinder National Hospital, University of Zinder, Zinder, Niger. 6. Department of Anesthesiology, Zinder National Hospital, University of Zinder, Zinder, Niger. 7. Department of General Surgery, Niamey National Hospital, University of Niamey, Niamey, Niger.
Abstract
BACKGROUND: Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS: This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study. RESULTS: During the study period, 2437 patients underwent digestive surgery, including 328 gastrointestinal stomas (13.5%). Patients classified ASA3 were 60.7% (n = 199). The median age was 12 years (IQ: 7-25). Children represent 64% (n = 210) of patients with ostomy. The sex ratio was 2.60. The stoma was performed in emergency in 96.3% (n = 316) of cases. Acute peritonitis was the main indication of the stoma in 70.73% (n = 232). The ileostomies accounted for 75.61% (n = 248). Ostomy was intended as temporary in 97.3% of cases (n = 319). Complications were observed in 188 patients (57.3%). Mortality was 14.02% (n = 46). The indigent status (OR: 4.15 [2.20-7.83], P = 000), ASA score 4 (OR: 2.53 [1.54-4.15], P = 0.0003), Altemeier class IV (OR: 4.03 [2.10-7.73], P = 0.0000) and ileostomy (OR: 2.7853 [1.47-5.29], P = 0.0018) were statistically associated with the occurrence of major complications. The mean time for stoma closure was 59.3 ± 14.5 days. CONCLUSION: Acute peritonitis was the main indication of digestive ostomy. The occurrence of major complications was associated with bad socioeconomic status, ASA4 score, Altemeier class IV and ileostomy.
BACKGROUND: Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS: This was a 4-year retrospective study (January 2013 to December 2016) at Zinder National Hospital (Niger). All patients with a digestive ostomy on an ileum or colic segment were included in the study. RESULTS: During the study period, 2437 patients underwent digestive surgery, including 328 gastrointestinal stomas (13.5%). Patients classified ASA3 were 60.7% (n = 199). The median age was 12 years (IQ: 7-25). Children represent 64% (n = 210) of patients with ostomy. The sex ratio was 2.60. The stoma was performed in emergency in 96.3% (n = 316) of cases. Acute peritonitis was the main indication of the stoma in 70.73% (n = 232). The ileostomies accounted for 75.61% (n = 248). Ostomy was intended as temporary in 97.3% of cases (n = 319). Complications were observed in 188 patients (57.3%). Mortality was 14.02% (n = 46). The indigent status (OR: 4.15 [2.20-7.83], P = 000), ASA score 4 (OR: 2.53 [1.54-4.15], P = 0.0003), Altemeier class IV (OR: 4.03 [2.10-7.73], P = 0.0000) and ileostomy (OR: 2.7853 [1.47-5.29], P = 0.0018) were statistically associated with the occurrence of major complications. The mean time for stoma closure was 59.3 ± 14.5 days. CONCLUSION: Acute peritonitis was the main indication of digestive ostomy. The occurrence of major complications was associated with bad socioeconomic status, ASA4 score, Altemeier class IV and ileostomy.
Authors: Samantha Hendren; Kerry Hammond; Sean C Glasgow; W Brian Perry; W Donald Buie; Scott R Steele; Janice Rafferty Journal: Dis Colon Rectum Date: 2015-04 Impact factor: 4.585
Authors: Lucinda Pérez Domínguez; María Teresa García Martínez; Nieves Cáceres Alvarado; Angeles Toscano Novella; Antonio Pedro Higuero Grosso; José Enrique Casal Núñez Journal: Cir Esp Date: 2014-06-23 Impact factor: 1.653